Quick: What pops into your mind when you see the word “Prenatal?” Maybe prenatal vitamin? Prenatal care? Prenatal appointment?
Okay, so, what is a prenatal appointment? A prenatal appointment is a set apart time where you receive care from your care provider such as an obstetrician or midwife. If a pregnant person is using a midwife, this care will be personalized to their specific health needs and desires for birth. If they are seeing an obstetrician, this care will be personalized to the OB’s practice. Whichever care provider they choose, they will have monthly, bi-weekly, and eventually weekly prenatal care throughout thier pregnancy.
In my role as a doula, I cannot provide any clinical care at all. My doula services are limited to educational, informational, emotional, and physical support. This means that I provide education and evidence based information on pregnancy, labor, birth, and breastfeeding. This comes in the form of private classes, answering questions, and providing evidence based websites for parents to do their own research. Emotional and physical support is provided through labor in the form of gentle, caring speech, rubbing the back, arms, legs, or hands, offering sips of water, offering ideas on different positions to find comfort, support the partner, the use of a rebozo, and many other comfort-level methods. None of these methods are clinical in any form.
In my doula role, I provide two client meetings before birth to help familiarize myself with my client’s birth wishes and to create a birth plan. These meetings are informational and educational.
Now to the nitty-gritty that may upset some doulas. This is not a slight on any doula. Please stay with me, because the purpose of this post will be evident in the final few paragraphs: I have never called my doula meetings “prenatals” “prenatal appointments” or anything closely related to “prenatal.” I call them “client meetings.” I could never get into the habit of calling what I provide as a doula, a “prenatal,” because I am not providing any prenatal, ie. clinical, care whatsoever. Prenatal appointments imply, to ME, an appointment with a care provider such as an obstetrician or midwife for the purpose of clinical care. What I am providing, as a doula, is education, information, and a 2-hour class on labor comfort measures. That to me does not equal a prenatal. It equals an informational/educational meeting.
I say all of the above, because this is an area where the change of roles is considerably different to me. As a student midwife, I am now, officially, attending prenatal appointments with a licensed midwife. Because as a doula I always called them “client meetings,” it was a huge deal when I switched to calling clinical appointments a prenatal. As a student midwife, the prenatal consists of all things clinical, as they usually do with a care provider. There’s the urinalysis, weight check, blood pressure, pulse, externally checking baby’s position, listening to heart tones, and discussion of any symptoms and/or concerns regarding the health of the pregnant woman. I can do none of these procedures during client meetings in the doula role, but I can do all these things during prentals as a student midwife under the supervision of a licensed midwife.
Using these two terms for what they are intended is a huge significance for me, now, as I switch between the doula role and the student midwife role. When I’m hired as a doula, they are client meetings. When I attend an appointment with a licensed midwife, they are called prenatals. I’m ecstatic that I have the privilege of attending prenatal appointments with a licensed midwife, and that I have the opportunity to perform all the clinical tasks which are part of a prenatal.
To some people it may be a matter of semantics, and that’s ok. To this writer it is a sign of a vastly different role: student midwife/ midwife apprentice.